摘要
目的:探讨胶体金免疫层析法(LFA)检测血清隐球菌多糖荚膜抗原(CrAg)在肺隐球菌病诊断中的应用价值及其相关因素。方法:收集2017年3月-2018年3月在福建省福州肺科医院就诊的患者,诊断肺隐球菌病(PC)33例(A组),非PC30例(B组),均行LFA检测血清CrAg,并对结果阳性患者行抗原半定量测定。结果:A组LFA阳性27例,B组LFA均为阴性,LFA检测的敏感性为81.82%(27/33),特异性为100%(30/30),阳性预测值和阴性预测值分别为100%和83.33%。LFA阳性率分别在临床诊断分型为无症状、慢性、急性,三组患者阳性率比较差异有统计学意义(P=0.004),三组半定量滴度比较差异有统计学意义(F=4.085,P=0.030);胸部影像分布为单侧单发、单侧多发、双侧多发,三组阳性率比较差异有统计学意义(P<0.001),单侧、双侧多发组半定量滴度比较差异无统计学意义(t=2.007,P=0.056);胸部影像病灶为孤立结节或肿块<2 cm,多发结节或肿块≥2 cm,斑片实变浸润影,混合病变,四组阳性率比较差异有统计学意义(P<0.001),后三组阳性检出者抗原滴度比较差异无统计学意义(F=2.050,P=0.152)。结论:LFA-CrAg对肺隐球菌病的诊断具有重要的临床意义,其阳性率与临床及影像学表现有关,其半定量滴度受到临床表现的影响。
Objective:To discuss the application and the relevant factors of using LFA to test Serum-CrAg in diagonizing pulmonary cryptococcosis.Method:Samples of patients who were treated from March 2017 to March 2018 in Fuzhou Lung Hospital in Fujian Province were collected.33 patients were diagonised Pulmonary Cryptococcosis(Group A),30 patients non-Pulmonary Cryptococcosis(Group B).LFA was used to test their Serum CrAg.Semi-quantitative determination of antigen was given to those patients with Positive Result.Result:In group A,LFA was positive in 27 cases,and LFA in group B was negative.The suspectivity of LFA test was 81.82%(27/33) and its specificity was 100%(30/30).The positive and negative predictive values were 100% and 83.33% respectively.The positive rate of LFA in clinical diagnosis was asymptomatic,chronic,acute,there was significant difference in the positive rate among the three groups(P=0.004),and there was significant difference in the semi-quantitative titer among the three groups(F=4.085,P=0.030).The distribution of chest images was unilateral,multiple and bilateral,there was significant difference in the positive rate among the three groups(P<0.001).There was no significant difference in the semiquantitative titers between unilateral and bilateral multiple groups(t=2.007,P=0.056).The chest imaging lesions were solitary nodules or masses<2 cm,multiple nodules or masses≥2 cm,spot consolidation infiltration,mixed lesions,there was significant difference in the positive rate among the four groups(P<0.001),but there was no significant difference in the antigen titer among the latter three groups(F=2.050,P=0.152).Conclusion:LFA-CrAg is of clinical significance to the diagnosis of pulmonary cryptococcosis.Its positive rate is related to the clinical and imaging manifestations.Its semi-quantitative titer is affected by clinical manifestations.
作者
方素芳
张宏英
黄明翔
FANG Sufang;ZHANG Hongying;HUANG Mingxiang(Fujian Medical University Teaching Hospital,Fuzhou 350008,China)
出处
《中外医学研究》
2019年第21期1-4,共4页
CHINESE AND FOREIGN MEDICAL RESEARCH
基金
福州市科技计划项目(项目编号:2017-S-133-4)
关键词
隐球菌抗原
胶体金免疫层析法
肺隐球菌病
诊断价值
因素
Cryptococcal antigen
Lateral flow immunoehromatographieas say
Pulmonary cryptococcosis
Diagnostic value
Factor
